CoMoBUZ Insider Briefing, Aug. 15, 2026

Mike's quick, weekly no-nonsense look at civic affairs in Columbia and Boone County, Missouri. This week, Mike has more on the Boone Health lawsuit against two of its former cardiologists who have opened a clinic in Columbia; reports on another dustup between MU President Mun Choi and the city council over policing downtown Columbia, and has an update on the first month of operations at Columbia’s new “Opportunity Campus” homeless services center. 

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The legal fight over cardiology in Columbia is entering a new phase. Missouri Heart Center is gone. Boone Health is rebuilding its own cardiology operation. Two longtime Columbia cardiologists have opened a competing independent practice, and now a judge may soon be asked to decide how much of that practice can remain open while Boone Health tries to enforce a noncompetition agreement. That is our lead this week, but it's not the only local institution facing a test. Downtown Columbia is confronting another round of violence near Ninth and Walnut, and Columbia's new opportunity campus is now fully operating, moving the debate over homelessness from promises and construction plans to actual results. From ComoBuzz.com, this is the Como Buzz Insider Briefing, a weekly look at the decisions, documents, and debates shaping Columbia and Boone County. I'm Mike Murphy. This week, three stories about institutions under pressure. First, Boone Health and the increasingly important question of whether protecting its cardiology program should restrict two experienced physicians from continuing to practice in Columbia. Then, another violent incident downtown has intensified, a public disagreement involving University of Missouri President Moon Choi, city leaders, and businesses around Ninth and Walnut downtown. And finally, the Opportunity Campus has been open long enough for the conversation to begin changing. The question is no longer what Columbia is building, it is now how the new system is actually working. We begin with Boon Health. The fight over cardiology in Columbia is no longer about the breakup of a Missouri Heart Center. That breakup has already happened. Missouri Heart closed in May, its physicians scattered. Boone Health began rebuilding its own cardiology program. Now the dispute is narrowed to something more immediate: whether two longtime Columbia cardiologists can continue operating a new independent practice while Boone Health asks the judge to enforce a non-competition agreement. The practice is pulse point cardiology. The doctors are Dr. James Fairlam and Dr. Martin Tobaku. And the public question is larger than a private contract dispute. Boone Hospital Center is a county hospital. Its assets are overseen by a five-member board of trustees elected by Boone County voters. So when Boone Health goes to court to protect its cardiology operation, the dispute involves a public-rooted institution, two physicians who want to remain in Columbia, and a specialty service that has already lost doctors during a difficult transition. The issue starts with the agreements between Boone Health and Missouri Heart Center. For years, Missouri Heart did much more than admit patients to Boone Hospital. Its physicians staffed cardiology services, and the group handled major management functions of the hospital's cardiovascular operation. By 2025, that relationship was deteriorating. Missouri Heart physicians had concerns about Boone Health's finances, staffing, and what they believed was insufficient investment in cardiology. On November 7, 2025, Missouri Heart formally notified Boone that its professional and management agreements would end on May 6, 2026. The group initially proposed continuing some relationship with Boone under a new structure, but Boone saw the separation differently. It warned that unwinding the agreement would be costly and complicated. Missouri Heart also explored outside financial backing. The disagreement moved into litigation and that outside partnership fell apart. Missouri Heart closed on May 6th. That left behind the provision now driving the new fight. The contract contains a broad non-competition covenant. For one year after the agreements ended, Missouri Heart and its physicians were restricted from participating in competing cardiovascular operations across a large territory that includes Columbia. The language includes cardiac diagnostic services, but the same section contains an important exception. It expressly says the noncompete does not prohibit one or more of the physicians from operating a private medical practice after the Boone relationship ends. That is where the dispute becomes difficult. Boone Health argues that the private practice exception does not allow Fairlam and Tobaku to recreate services that compete directly with the hospital. Boone says the doctors may see patients independently, but the contract bars them from owning or investing in competing diagnostics services or facilities. Boone also points to its financial investment. The hospital says it purchased Missouri Heart's diagnostic equipment and facility for more than $1 million in 2011, then paid Missouri Heart millions over the years to staff and manage Boone's cardiology operation. In Boone's view, Pulse Point crossed the contractual line when it opened less than six miles from the hospital and began offering diagnostic services. Fairlam and Tobaku see the same language differently. Their position is straightforward. The contract expressly says they may operate a private medical practice. That raises the practical question a judge will likely soon have to answer. What does a private cardiology practice mean if the doctors are prohibited from providing services that are ordinarily part of cardiology? The contract preserves private practice. At the same time, it preserves broad restrictions on competing cardiovascular services. Boone can argue, and is that the agreement never promised an unrestricted cardiology business. The doctors can argue that an exception allowing private practice becomes largely meaningless if a normal cardiology office cannot provide diagnostics. Judge J. Hasbrook Jacobs of Missouri's 13th Circuit in Boone County is expected to confront that issue soon. Boone is expected within the next couple of weeks to seek temporary injunctive relief. That matters because this is not simply a case waiting for a final judgment months from now. The temporary order could restrict what Pulse Point is allowed to do while the lawsuit proceeds. Pulse Point is already open on Nyphong Boulevard in Southwest Columbia. Fairlam and Tobaku are seeing patients. Boone says the practice is providing diagnostics that violate the agreement. The doctors say they are operating the private practice the same agreement expressly permits. There is also a human side to why this practice exists. Fairlam is practicing Columbia for about two decades. Tobaku came to Missouri Heart after Fairlam helped recruit him. Fairlam became his mentor, colleague, and close friend. When Missouri Heart collapsed, Fairlam considered leaving Columbia. Washington University offered him an associate professor position. He stayed. Tobaku has been preparing to leave too. He was planning to build a cardiology practice in Metropolitan Atlanta, focused in part on underserved communities. He changed course after seeing what the Missouri Heart breakup was doing to Fairlam. Tobaku decided to build in Columbia instead. That became Pulse Point. Boone Health, meanwhile, says Missouri Health's departure forced it to rebuild cardiology at a significant operational and financial cost. Boone says its new program is stabilizing, patient volumes are returning, and there is currently no wait for cardiology diagnostic testing. Those facts matter because there are legitimate interests on both sides. Boone has an obligation to protect the hospital program in which it says substantial money and resources were invested. Fairlam and Tobaku say they are trying to remain in Columbia and operate independently after Missouri Heart ceased to exist. And Columbia has already lost cardiologists during the breakup. That is the accountability frame here. What exactly is the public interest Boone Health is protecting through this lawsuit? And how should the interest be balanced against keeping experienced cardiologists practicing in the community? The court will answer the legal question, but the broader civic question belongs to Boone Health's trustees, its leadership, and the public whose hospital's assets they oversee. Tobaku has questioned why there was so little visible public pressure while Missouri Heart was falling apart and physicians were leaving. That does not determine who is legally right, but it does identify what is at stake now. Boone Health says it is protecting a cardiology operation it has to rebuild. Fair Lamb and Tobaku say they are trying to practice in the community they chose to stay in. Judge Jacobs is likely to begin deciding within weeks how much of Pulse Point can continue while the lawsuit moves forward. The legal fight is over contract language. But the public consequence is whether Columbia preserves more cardiology capacity, physician choice, and experienced doctors, or loses another part of what disappeared when Missouri Heart came apart. You're listening to the Como Buzz Insider Briefing from Como Buzz.com. Now to downtown Columbia, where another serious incident has changed the public safety debate. For several weeks, University of Missouri President Moon Choi and city leaders have been arguing publicly over crime, police resources, and the condition of downtown. Columbia's long-planned opportunity campus is now operating, bringing overnight shelter, day services, meals, medical care, and case management together on one site along the business loop. The opening marks the end of a multi-year effort to replace a scattered network of homeless services with a centralized campus designed to operate around the clock. The nonprofit Voluntary Action Center built the $18.6 million campus at 1300 Bowling Street next to the city's power plant. Construction began in early 2024. The project includes two primary buildings. It is now the home of the Voluntary Action Center's headquarters, that's the Cindy Mustard Resource Center, and a larger shelter and client services building. The concept was straightforward but ambitious. Instead of asking people experiencing homelessness to move between churches, shelters, clinics, and nonprofit offices across Columbia, the campus was designed to put many of those services into one place. The resource center opened first this spring. VAC moved its own operations there in April, along with expanded food and emergency assistance space and room for partner agencies. Then came the day center, New Day Columbia, formerly known as Turning Point, began operating at the campus in late June. It provides showers, laundry, lockers, mail service, computer access, charging stations, and other basic services during the day. That move was significant because Turning Point had operated for years from the Wilkes Boulevard United Methodist Church, where an aging building and limited accessibility had become increasingly difficult. Meal service followed. Loaves and Fishes moved its evening meal program to the campus in early July. And on July 13th, the final major piece opened, the Waypoint Overnight Shelter. The shelter has 150 beds and is designed to operate year-round. It also includes overflow space, private rooms for people who are sick, specialized sleeping areas for veterans and people with sensory needs, showers, laundry facilities, and a kennel space for pets. That last piece is not incidental. The new facility includes indoor and outdoor kennel runs, a pet washing area, and spacer veterinary exams. The campus also includes an on-site medical center, secure storage, computer access, and dedicated case management offices. That case management is one of the central ideas behind the project. The objective is not simply to provide a bed for the night, it is to connect people with mental health treatment, substance abuse services, employment assistance, medical care, and housing resources, and to reduce duplication among agencies that may already be working with the same person. VAC has said that roughly 30 nonprofit and service organizations are expected to participate on-site or through coordinated partnerships. The scale of the public investment is also important. The City of Columbia committed $3.1 million in Federal American Rescue Plan money to construction. Boone County contributed $350,000, and the state of Missouri pledged up to $7.5 million. The city also committed just over $1 million a year in general fund money for homeless services in 2026. Those operating contracts include nearly $585,000 for overnight emergency shelter and about $432,000 for daytime services and warming and cooling operations. City staff said that funding did not represent a new spending increase. It continued money already budgeted for those services. The larger public question now is whether consolidating services produces better results. Columbia's homeless population has remained near 300 people in recent annual counts. The city reported 309 people experiencing homeless in 2025, compared with 323 in 2024 and 270 in 2023. Opportunity campus supporters argue the new model should make services more organized and more effective because people can receive multiple forms of help without traveling across town. But the campus has also faced concerns from nearby businesses and residents. Those concerns include loitering, litter, foot traffic, neighborhood safety, and whether a large shelter could attract more homeless people to Columbia. VAC leaders have consistently rejected the idea that the campus will become a regional magnet. Executive Director Ed Stansbury said the organization intends to focus primarily on Boone County residents while still providing immediate shelter when someone is in need. Shelter Director Jessica McNear has also emphasized security and neighborhood relations. Jessica McNear will join us today in a few minutes on the Eagle Eye Drive at five. The campus is staffed 24 hours a day. A trained safety and security team is on site around the clock, and nearby businesses and residents are being given a direct number to reach that team. McNear has said the operating philosophy will be trauma informed with an emphasis on de-escalating problems before they require police involvement. That is another measure worth watching. Campus leaders have said one goal is to reduce non-emergency calls to Columbia police by handling more behavioral issues and minor conflicts internally. The Opportunity Campus is no longer a proposal or a construction project. It is now an operating part of Columbia's homeless services system. The next question is whether the promises behind the campus, more coordinated services, fewer barriers, fewer neighborhood problems, and better long-term outcomes show up in the results. And that's where this story moves on to next. Three stories this week, and there's a common thread running through all of them. Boone Health is being asked to explain what public interest is served by restricting two cardiologists who want to remain in the community. City Hall is being pressed to show what it intends to do when violence repeatedly occurs in the same downtown area. And the Opportunity Campus is entering the stage where major public investment can begin to be judged by performance rather than intention. Different subjects, same basic standard, what was promised, what is actually happening, and what comes next. That is where our focusing, that is where our reporting will stay focused. You can follow all these stories along with our continuing coverage of Columbia and Boone County government, courts, health care, and public finance at Como Buzz.com. We'll be watching for the next court filings in the Boone Health Cardiology case, the city's response to the renewed downtown violence, and the first meaningful operating results from the Opportunity Campus. For Como Buzz.com, I'm Mike Murphy. Thanks for listening. I'll see you next week.